This psychiatry weblog, authored by two Harvard University-trained psychiatrists and former lecturers at Harvard Medical School, offers you psychiatric news and commentary about brain disorders, mental dysfunction, psychological illness, and mental health wellness.
This psychiatry weblog is dedicated to providing to you psychiatric news and commentary about brain disorders, mental dysfunction, psychological illness, and mental health wellness. Enjoy!
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Ms. Carol Gignoux, (please see bio below), is an expert ADHD coach and lecturer who will be giving a five-session seminar series entitled: The Secrets to Mastering One"s ADHD. Topics will include: the secrets to mastering one's ADHD at work, in one's intimate relationship, as a parent, in communications with others, and in organizing one's home environment. Cost is $199 for all five one hour seminars. Dates are: March 13th, 27th, April 17th, May 8th, and May 22. All seminars with be held on Saturdays from 10AM to 11AM in the offices of the New England ADHD Treatment Center c-directed by Dr. Jeffrey Speller and Dr. Tanya Korkosz. The address is: Six Courthouse Lane, Unit 12, Chelmsford, MA 01824. Enroll today by calling Carol Gignoux at 866 995 9444. The first twenty individuals to enroll will receive a free brief one-on-one ADHD coaching session from Carol.
Carol Gignoux's Bio
Carol Gignoux is well established as an expert
within the ADHD coaching, consulting and training profession with over 35 years
experience working with ADHD and over 16 years as a professional coach. Carol’s
passion is providing services that transform the lives of people with ADHD. Carol
specializes in coaching teens and adults who want to move beyond issues with
ADHD and develop the skills and confidence to achieve better results in their
academic, professional and personal lives.
Carol is also trained as an Executive Coach. She
has worked with executives and managers to create high functioning, successful
businesses locally as well as nationwide. She was an active board member of the
International Coaching Federation New England (ICF) for 3 years and is a
founding board member of the Institute for the Advancement of ADHD Coaching
that is the responsible certifying body for ADHD Coaches worldwide. Carol is
qualified at the Senior Certified ADHD Coach level.
Carol speaks and delivers tele classes and seminars
locally and nationally on a variety of important and relevant topics to those
with ADHD. She trains and supervises new ADHD coaches across the country.
Presently, Carol is writing a book about the work
she has done with clients to help them powerfully overcome the barriers that
have held them back so they can purposefully and confidently move forward to a
better future.
Mental health professionals have long wondered about the
relationship between bright lights and sexual performance. An article published
in Medical News Today June 15, 2009, “Can Light Therapy Improve Your Sexual
Functioning? New Promising Data,” examines this issue. The findings of this
research were published in the December 2008 issue of Child Development. The researchers studied,“….9 male patients with nonorganic
sexual dysfunction. Subjects (age 39 - 60) were consecutively recruited in the
outpatient clinic of the Urology Department of the University of Siena Medical
Center on the basis of a diagnosis of primary (i.e. not due to another illness
or to a medication or a drug of abuse) hypoactive sexual desire disorder (HSDD,
n = 2), sexual arousal disorder (SAD, n = 6), and orgasmic disorder (OD, n = 1)
and the absence of a mood disorder, as assessed via the Mini International
Neuropsychiatric Interview. Subjects were randomly assigned to active light
treatment (ALT) or placebo light treatment (L-PBO) and assessed at baseline and
after 2 weeks of ALT/L-PBO treatment via the Structured Clinical Interview for
DSM-IV-Sexual Disorders (SCID-S) and via a sexual satisfaction self-report,
which asked them to rate on a scale from 1 to 10 their level of sexual
satisfaction.
The ALT consisted of daily exposure to a white fluorescent light box
(Super-Lite 3S, fitted with an ultraviolet filter and rated at 10,000 lx at a
distance of 1 m from screen to cornea) for 30 min as soon as possible after
awakening, between 7.00 a.m. and 8.00 a.m. The L-PBO was an identical light box
fitted with a neutral density gel filter to reduce light exposure to 100 lx.”
The results of this study were very interesting. “………After 2 weeks of
treatment, 3 of the 5 patients randomized to ALT no longer met the SCID-S criteria
for a sexual disorder whereas the sexual disorder was still present in all the
4 patients in the L-PBO group. A significant (p = 0.001) improvement in sexual
satisfaction was observed in the ALT group, whereas no improvement was observed
in the L-PBO group (p =0.39).”There are
a number of important implications of this study. First, individuals who are
experiencing sexual dysfunction should consult there health care provider to
see if they are a candidate for light therapy. Second, mental health professionals
who treat patients with sexual dysfunction should consider light therapy.
Third, patients who are diagnosed with SADD should monitor their sexual
functioning to determine if there has been any improvement. And, last of all,
public health professionals should educate the public about the advantages of
light therapy for the treatment of sexual dysfunction.
The Bottom Line:
The results of this study suggest that individuals who have sexual dysfunction
should light therapy as a possible treatment.
Sources: See blogposts in Psychiatric Disorders: General, Depression
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Mental health professionals have long wondered about the
relationship between life expectancy and having a higher purpose in life. An
article published in Medical News Today June 16,2009, “Having A Higher Purpose In Life
Reduces Risk Of Death Among Older Adults,” examines this issue. The researchers studied,“…..studied 1,238 community-dwelling
elderly participants from two ongoing research studies, the Rush Memory and
Aging Project and the Minority Aging Research Study. None had dementia. Data
from baseline evaluations of purpose in life and up to five years of follow-up
were used to test the hypothesis that greater purpose in life is associated
with a reduced risk of mortality among community-dwelling older persons…Purpose
in life reflects the tendency to derive meaning from life's experiences and be
focused and intentional…” The results of this study were very interesting.
“….After adjusting for age, sex, education and race, a higher purpose of life
was associated with a substantially reduced risk of mortality. Thus, a person
with high purpose in life was about half as likely to die over the follow-up
period compared to a person with low purpose. The association of purpose in
life with mortality did not differ among men and women or whites and blacks,
and the finding persisted even after controlling for depressive symptoms,
disability, neuroticism, the number of medical conditions and
income….Significant associations with mortality were found with three specific
items on the purpose of life questionnaire to determine the study participants'
agreement with the following statements: "I sometimes feel as if I've done
all there is to do in life;" "I used to set goals for myself, but
that now seems like a waste of time;" and "My daily activities often
seem trivial and unimportant to me." There are several important
implications of this study. First, older individuals who are considering
retirement should aim for retirement activities that give true meaning to one’s
life. Second, mental health professionals who treat older patients should
screen all of these patients for the quality of their lives. Third, public
health professionals should educate the public about the importance of having a
higher purpose to life. The researchers concluded, “….finding that purpose in
life is related to longevity in older persons suggests that aspects of human
flourishing particularly the tendency to derive meaning from life's experiences
and possess a sense of intentionality and goal-directedness contribute to successful
aging….having a sense of purpose in life is important across the lifespan,
measurement of purpose in life in older persons in particular may reveal an
enduring sense of meaningfulness and intentionality in life that somehow
provides a buffer against negative health outcomes."
The Bottom Line:
The results of this study suggest that older individuals should seek a higher
purpose in life to decrease their mortality risk.
Sources: See blogposts in Psychiatric Disorders: General, Depression
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Mental health professionals have long wondered about the
impact of changing residences on children. An article published in Medical News
Today June 5, 2009, “Changing Residences Associated With Increased Risk Of
Suicidal Behavior Among Children,” examines this issue. The results of this
study were published in the June 2009 issue of Archives of General
Psychiatry. The researchers
studied,“…..data from Danish
national registries to identify all children born between 1978 and 1995.
Between 11 and 17 years of age, 4,160 of these children attempted suicide based
on hospital records, and 79 completed suicide. For each suicide attempt or
completion, the researchers selected 30 control children who were the same sex
and age.” And the results?“….Compared
with the control children, those who attempted suicide were more likely to have
changed residences frequently-55.2 percent of suicidal children and 32 percent
of controls had moved more than three times, and 7.4 percent had moved more
than 10 times (compared with 1.9 percent of controls). Frequent moves were also
more common among children who completed suicide….A dose-response relationship
was observed for both attempted and completed suicide, meaning that the more
often a child changed addresses, the more likely he or she was to have
attempted or completed suicide. The associations remained significant after the
researchers controlled for other factors, such as birthplace and parents'
mental health.” There are several important implications of this study. First,
parents of adolescent children should greatly minimize the number of times that
they change residences during the children’s adolescent years. Second, school
professionals who have new children in their classroom who have reported
frequent family moves, should be alert to the possibility of suicidal thinking.
Third, mental health professionals who treat suicidal adolescents should
investigate how many times these patients have changed residences. And, fourth,
public health professionals should educate parents about the risks of frequent
moves on their adolescent children’s mental health. The researchers conclude,
“…..The breakdown of connections with peers, discontinuation of group
activities, distress and worries related to the new environment are potentially
psychologically distressing events for young children. Frequent exposures to
these events can be stressful and confusing and may affect their psychosocial
well-being, thus increasing their intention toward ending their life if they
are unable to cope…In addition, moving is stressful for parents and may result
in their inability to attend to their children's emotional needs….Children may
feel ignored and have no one to communicate with. A suicide attempt may, to
some extent, express the need for more attention from their parents."
The Bottom Line: The results of this
study suggest that adolescents who change residences frequently may be at risk
of suicidal behaviors.
Sources: See blogposts in Psychiatric Disorders: General, Depression
Additional Resources:
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Mental health professionals have long wondered about the
relationship between shaming children and their subsequent behavior. An article
published in Medical News Today December 28, 2008, “Shaming Some Kids Makes
Them More Aggressive,” examines this issue. The findings of this research were
published in the December 2008 issue of Child Development. The researchers studied,“…..163 children ages 10 to 13, from Michigan middle schools.
Almost all were white, and slightly more than half (54 percent) were males…A
few weeks before participating in the on-line experiments, the young people
filled out a questionnaire designed to assess their levels of self-esteem and
narcissism…….For the experiment, children were told they would be competing on
an Internet reaction-time game called FastKid! against an opponent of the same
sex and age from a school in Columbus,
Ohio (where the Buckeyes live!).
In reality, there was no opponent; the computer controlled all events. Those
who were randomly selected for the "shame condition" were told that
their opponent was one of the worst players in the supposed tournament, and
they should easily win; when they lost, their last-place ranking was displayed
on a website they believed that everyone could see. Children were told they
could blast their opponent with a loud noise after winning a trial.” And the
results of the study? “ … The narcissistic kids were more aggressive than
others, but only after they had been shamed….Narcissists seem highly motivated
to create and maintain a grandiose view of self…They tend to interpret social
situations in terms of how they reflect on the self, and they engage in
self-regulatory strategies to protect self-esteem when they need to. As
shameful situations constitute a threat to grandiosity, narcissistic
shame-induced aggression can likely be viewed as defensive effort to maintain
self-worth…[the researchers] …found that high self-esteem increased
narcissistic shame-induced aggression.” There are several important
implications of this study. First, parents of children with high degrees of
narcissism should not engage in shaming as a way to control their child’s
behavior. Second, school professionals should also avoid shaming their students
with high levels of narcissism. Third, mental health professionals who treat
children and adolescents who exhibit aggressive behaviors should screen these
patients any past events of shaming. And, last of all public health
professionals should educate both parents and school professionals about the
negative consequences of shaming.
The Bottom Line:
The results of this study suggest that shaming narcissistic adolescents may
lead to aggressive behavior.
Sources: See blogposts in Psychiatric Disorders: General
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Mental health professionals have long wondered about the
relationship between adolescent smoking and adult depression. An article
published in Medical News Today February 1, 2009, “Possible Link Between Teen
Smoking And Adult Depression,” examines this issue. The findings of this
research were published in 2009 online in the journal Neuropsychopharmacology,
The researchers “……injected adolescent rats twice daily with either nicotine or
saline for 15 days. After the treatment period ended, they subjected the rats
to several experiments designed to find out how they would react to stressful
situations as well as how they would respond to the offering of rewards.” And
the results? The researchers found, “…that behavioral changes symptomatic of
depression can emerge after one week of nicotine cessation and -- most
surprising -- that even a single day of nicotine exposure during adolescence
can have long-lasting effects….the rats who were exposed to nicotine engaged in
behaviors symptomatic of depression and anxiety, including repetitive grooming,
decreased consumption of rewards offered in the form of sugary drinks and
becoming immobile in stressful situations instead of engaging in typical
escape-like behaviors. The researchers were able to alleviate the rats'
symptoms with antidepressant drugs or, ironically, more nicotine.”
The researchers conclude, “…..Scientists have long known there is a connection
between smoking and mood disorders, but they have not been able to say for sure
that one causes the other because there are so many factors influencing human
behavior. This study provides support for the idea that smoking can induce
symptoms of depression, and paradoxically, can also be a way of managing those
same symptoms and enhancing the risk for addiction….The message to young people
of course is don't smoke and don't even try it….If they do smoke, they need to
be aware of the potentially long-term effects that recreational or even
occasional cigarette smoking can have on their systems."
The Bottom Line:
The results of this study suggest that adolescent smoking may lead to adult
depression.
Sources: See blogposts in Psychiatric Disorders: General, Depression
Additional Resources:
For related articles on the
Web, click on: “Sphere: Related Content” located at the bottom of this
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Mental health professionals have long wondered about the
relationship between obsessive tendencies in children and their mental health
as adults. An article published in Medical News Today March 5, 2009, “Obsessive
Symptoms In Childhood Can Multiply The Probabilities Of An Obsessive Compulsive
Disorder In Adulthood,” examines this issue. The researchers studied, “…one
thousand people…assessed the evolution of two variables in participants at ages
11, 26 and 32: the repeated presence of obsessive ideas (e.g. recurrent and
undesired thoughts to harm others) and compulsive rituals (a need to wash their
hands constantly, to check up on small everyday tasks to prevent harm or
repeatedly carrying out activities that seem meaningless, etc.). The results of
the study were interesting. “…Based on the analysis of these data…there is a
correlation between obsessions and compulsions in childhood (when study members
were age 11) and the probability of suffering from an obsessive-compulsive
disorder as an adult (observed at ages 26 and 32 among participants). More
specifically, the girls and boys in the study who showed symptoms of obsessive
or compulsive behaviour at 11 - a total of 8% of the population studied - were
six times as likely as others to suffer from an obsessive-compulsive disorder
in adulthood.” There are several important implications of this study. First, parents
of children who exhibit obsessive symptoms should consult a qualified mental
health professional to determine their child’s current and future risk of OCD.
Second, mental health professionals who treat adults patients diagnoses with
OCD should routinely screen for a history of childhood obsessive symptoms. Third,
educators and school personnel who observe obsessive tendencies in their pupils
should consult with a guidance professional to determine if intervention is
warranted. And, fourth, public health professionals should educate the public
about the link between childhood obsessive symptoms and adult OCD. The
researchers conclude, “….There is nevertheless no need to become alarmed with
the cases of children who manifest these symptoms, since they are very common
amongst children aged 8 to 10, while the percentage of adults with this disorder
does not reach 2%. What should be done is focus on preventive measures for
these children, since we've seen that the risk is much lower amongst the rest
of the population."
The Bottom Line:
The results of this study strongly suggest that children with obsessive
symptoms are at risk for developing adult OCD.
Sources: See blogposts in Psychiatric Disorders: General and Psychiatric Disorders: OCD, Youtube. Adolescents
Additional Resources:
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Mental health professionals have long debated about the
relationship between strong religious beliefs and mental health. An article
published in Medical News Today March 5, 2009, “Believing In God Can Help Block
Anxiety And Minimize Stress, According To New University Of Toronto Research,”
examines this issue. The article reports on two studies conducted by
researchers at the New University Of Toronto Research. The researchers
studied,“…participants [who] performed
a Stroop task - a well-known test of cognitive control - while hooked up to
electrodes that measured their brain activity.” The results of the study were
interesting. “…Compared to non-believers, the religious participants showed
significantly less activity in the anterior cingulate cortex (ACC), a portion
of the brain that helps modify behavior by signaling when attention and control
are needed, usually as a result of some anxiety-producing event like making a
mistake. The stronger their religious zeal and the more they believed in God,
the less their ACC fired in response to their own errors, and the fewer errors
they made.” The researchers conclude, “…You could think of this part of the
brain like a cortical alarm bell that rings when an individual has just made a
mistake or experiences uncertainty….We found that religious people or even
people who simply believe in the existence of God show significantly less brain
activity in relation to their own errors. They're much less anxious and feel
less stressed when they have made an error."
The Bottom Line:
The results of these studies strongly suggest that believing in God can reduce
your anxiety about making errors.
Sources: See blogposts in Psychiatric Disorders: General
Additional Resources:
For related articles on the
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Mental health professionals have long debated about the relationship
between marital stress and the mental health of women. An article published in
Medical News Today March 5, 2009, “Marital Strain Harms Women More Than Men,”
examines this issue. The article reports on a study presented at the American
Psychosomatic Society's 2009 annual meeting in Chicago. The researchers studied, “…276
couples who had been married for an average of 20 years and were aged between
40 and 70 years….The participants filled in several questionnaires…covering
positive aspects of marriage quality (eg mutual support, emotional warmth,
friendliness, confiding in each other), negative aspects of marriage quality
(eg arguments, hostility, disagreements) and symptoms of depression (not
necessarily full blown clinical depression)…
The participants also underwent physical exams where blood pressure, waist
measurement, good cholesterol, fasting glucose and blood fats were measured.”
The results of the study were concerning. “….Women who reported more marital
strain had more metabolic syndrome symptoms, and that association can be
explained by the fact they also reported more depressive symptoms." There
are several important implications of this study. First, adult married women who
are experiencing significant marital stress should consult a qualified mental
health professional to determine their current and future risk of medical
disorders. Second, mental health professionals who treat adult married women
who report marital stress should routinely screen for medical problems in these
patients. Third, spouses of adult married women who are experiencing marital
stress should educate themselves with the help of a qualified mental health
professional to understand they can help their spouse reduce marital stress. Fourth,
public health professionals should educate the public about the link between marital
stress and medical disorders. The researchers conclude, “….improving aspects of
intimate relationships might help [a woman’s] emotional and physical
well-being".
The Bottom Line:
The results of this study strongly suggest marital stress can harm a woman’s
health.
Sources: See blogposts in Psychiatric Disorders: General
Additional Resources:
For related articles on the
Web, click on: “Sphere: Related Content” located at the bottom of this
blog post.
For related books or blog
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Mental health professionals have long wondered about the
relationship between childhood sexual abuse and adult mental health. An article
published in Medical News Today June 9, 2009, “'Strong Link' Between Childhood
Sexual Abuse And Suicide Attempts In Women,” examines this issue. The article
reports on the results of a study presented at the Annual Meeting of the Royal
College of Psychiatrists in Liverpool. The
researchers studied, “…..data from the 2000 National Psychiatric Morbidity
Survey.” The results of the study were concerning. “…sexual abuse was three
times more common in women than men - some 1.6 per cent of men report sexual
abuse, compared to 5.2 per cent of women….Women attempt to kill themselves more
often than men (3.5 per cent of women compared to 5.1 per cent of women) and the
number of suicide attempts attributable to sexual abuse was stronger in women
than men….sexual abuse in childhood made women far more likely than men to
attempt suicide…women react to trauma more strongly than men, perhaps
accounting for the strong link between sexual abuse and suicide.” There are a
number of important implications of this study. First, adult women with
childhood sexual abuse histories should consult a qualified mental health
professional to determine their current and future risk of suicidal thinking.
Second, mental health professionals who treat adult women with childhood sexual
abuse histories should routinely screen for suicidal thinking in these
patients. Third, spouses of adult women with childhood abuse histories should
educate themselves with the help of a qualified mental health professional to
understand the current and future risk of suicide in these women. Fourth, public
health professionals should educate the public about the link between childhood
sexual abuse and the risk of suicide in adult women. The researchers state,
“….[Women] who have been sexually abused have low self esteem, ironically blame
themselves for the abuse, and all their levels of confidence about all sorts of
things are reduced…Lowering your self esteem like that is associated with all
sorts of mood symptoms and these are the bed out of which arises suicidal
ideation. A proportion of those will then go on to attempt suicide and of those
some will be successful."
The researchers conclude, “…psychiatrists [must] deal with the issue of sexual
abuse in a more forceful way…finding out whether a patient had been sexually
abused opened up the possibility of treatment, as there were specific ways a
psychiatrist could intervene and help….The patient may have post-traumatic
stress disorder and you can treat that; they may have low self esteem and you
can address that too and you might make life better for that person and they
will be less inclined to think of suicide."
The Bottom Line:
The results of this study strongly suggest that childhood sexual abuse
increases the risk of suicide in adult women.
Sources: See blogposts in Psychiatric Disorders: General
Additional Resources:
For related articles on the
Web, click on: “Sphere: Related Content” located at the bottom of this
blog post.
For related books or blog
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content, type in the keywords into “Amazon
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Mental health professionals have long wondered about the
impact of parental behavior on a child with Obsessive Compulsive Disorder. An
article published in Medical News Today June 18, 2009, “Wrong Type Of Help From
Parents Could Worsen Child's OCD, 18 Jun 2009,” examines this issue. The article reports on study recently published in the Journal of Consulting and Clinical Psychology. The researchers studied, “….49 children between 6 and 18 with OCD and their families who came to UF for a type of treatment called cognitive-behavioral therapy. This form of therapy involves exposing children to their fears and teaching them better ways to respond and cope. During the sessions, therapists teach parents how they should deal with their child's OCD, too….Prior to the start of the 14-session therapy, the
researchers gauged how severe each child's condition was and compared it to how
many accommodating behaviors parents reported…. These accommodations can be
anything that makes the symptoms of OCD less impairing, from reassuring a child
that his hands are clean and his baby brother is OK to even doing his homework
for him or buying objects that make the child feel safe.” The results of the
study were very interesting. “After the treatment, researchers noticed a
significant decrease in how often families were assisting children with OCD
behaviors and rituals. Children whose families had the biggest decrease in
these accommodations also had the biggest improvement in their OCD symptoms.”
There are several important implications of this study. First, parents who
behave with the best of intentions may not be serving the best interests of
their OCD child. Second, mental health professionals who treat
OCD children must educate parents about appropriate behaviors in the home
setting. Third, school professionals who have OCD children in the classroom
must be trained in the best interventions for these children during the school
day. And fourth, public health professionals must educate parents of OCD
children about the needs their children. The researchers end by saying, “We see
it with adults' spouses and partners, too. In trying to be helpful to the
person with OCD, they end up making the problem worse."
The Bottom Line: The results of this
study strongly suggest that parents can unintentionally worsen their child’s
OCD.
Sources: See blogposts in Psychiatric Disorders: General and Psychiatric Disorders: OCD, Youtube. Adolescents
Additional Resources:
For related articles on the
Web, click on: “Sphere: Related Content” located at the bottom of this
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Mental health professionals have long wondered about the
relationship between fatherhood and mental health. An article published in
Medical News Today June 19, 2009, “Fatherhood Influences Men In Mental Health
Decisions,” examines this issue. The article reports on an “…national online
survey conducted within the United States by Harris Interactive on behalf of
The American Psychiatric Association between June 12-16, 2009 among 2,274
adults age 18+, 1040 of whom were male; 235 of those males were fathers or
legal guardians.” The results were interesting. “…the survey indicated that
fathers are more likely to take their mental health seriously for the sake of
their children. Over 90 percent of men surveyed said their role as a father or
legal guardian would have an impact on their decision to seek help if they were
feeling depressed…Survey respondents were more likely to say they would
encourage their fathers to seek help for depression if they are parents
themselves. More than 90 percent of parents or guardians who still have contact
with their fathers said they would be likely to encourage their own fathers to
seek help for depression if they felt it was interfering with his work or relationships.”
The Bottom Line:
The results of this survey suggest that men when they become father take their
own mental health more seriously.
Sources: See blogposts in Psychiatric Disorders: General and Psychiatric Disorders: Depression, Youtube
Additional Resources:
For related articles on the
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Mental health professionals have long wondered about the
relationship family obligation and depression in adolescents. An article
published in Medical News Today June 5, 2009, “Risk Of Teenage Depression
Symptoms Lowered By Family Obligation In Chinese Homes,” examines this issue.
The article reports on a new study published in the Journal of Family
Psychology. The researchers
studied, “….218 Chinese-American teenagers over a two-year period caring
for siblings or helping elders.” The results of the study were interesting. The
researchers found that “…..14-year-olds who reported a greater sense of family
obligation reported fewer depressive symptoms by the time they reached 16…..As
participants grew older, their actions to help and support their families
decreased. However, their attitude and respect toward their families remained
stable, indicating that immigrant adolescents continue to endorse their
traditional cultural values even when their behaviors suggest they are becoming
less traditional.” There are several important implications of this study.
First, parent of adolescents should require that their children be involved and
engaged in the care their family members. Second, school professionals should
give adolescents opportunities to assist their younger schoolmates. Third, day
care providers should attempt to hire adolescents for summer jobs caring for
smaller children. Fourth, mental health professionals who are treating
depressed adolescents should encourage them to become involved in the care of
family members. And, fifth, public health professionals should educate the
parents of adolescents about the benefits of their children being involved in
the care of family members
The Bottom Line:
The results of this study strongly suggest that adolescents who care for family
members significantly reduce the risk of depression.
Check out The Parent's Guide to Understanding Adolescent Depression
authored by Dr. Jeff and Dr. Tanya and now available in a great
informational website hosted by Squidoo.com. Below is a sneak preview
of the website's Table of Contents:
Sources: See blogposts in Psychiatric Disorders: General and Psychiatric Disorders: Depression, Youtube
Additional Resources:
For related articles on the
Web, click on: “Sphere: Related Content” located at the bottom of this
blog post.
For related books or blog
posts with related content in Dr. Jeff’s and Dr. Tanya’s Blog type in the
keywords into “Google Search” located in
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content, type in the keywords into “Amazon
Search” on the Amazon banner located in the side bar.
Mental health professionals have long wondered about the
relationship between napping and mental health in young children. An article
published in Medical News Today June 11, 2009, “Discovery Of Relationship Between Napping, Hyperactivity,
Depression And Anxiety In Young Children,” examines this issue. The article
reports on a research abstract presented on Monday, June 8 at SLEEP 2009, the
23rd Annual Meeting of the Associated Professional Sleep Societies. The
researchers studied, “….62 children between the ages of 4 and 5 who were
classified as either napping (77 percent) or non-napping (23 percent) based on
actigraphy data. Napping children napped an average of 3.4 days per week. Of
the sample, 55 percent were white-non Hispanic and 53 percent were male. Caretakers
reported their child's typical weekday and weekend bedtime/rise time, napping
patterns, family demographics, and completed a behavioral assessment of the
child. Actigraphy data for each child was collected continuously for seven to
14 days.” The results of this study were interesting. “..children between the
ages of 4 and 5 who did not take daytime naps were reported by their parents to
exhibit higher levels of hyperactivity, anxiety and depression than children
who continued to nap at this age.” There are several important implications of
this study. First, parents of young children show insure that their young
children get adequate daily naps. Second, day care providers and preschool
teachers should confer with parents of any child in their care that is showing
signs hyperactivity, anxiety, and depression in order to insure that the child
is getting adequate nap time. Third, mental health professionals who treat
young children who are hyperactive, depressed, and anxious should screen for
whether the child receivership adequate napping time during the day. Fourth,
public health professionals should be more aggressive in educating parents of
young children about the mental health risks of inadequate nap time. The researchers conclude that, “…there is a lot of individual variability in when
children are ready to give up naps. I would encourage parents to include a
quiet 'rest' time in their daily schedule that would allow children to nap if
necessary."
The Bottom Line:
The results of this study strongly suggest that inadequate nap time in young
children puts them at risk for hyperactivity, depression, and anxiety.
Check out The Parent's Guide to Understanding Adolescent Depression
authored by Dr. Jeff and Dr. Tanya and now available in a great
informational website hosted by Squidoo.com. Below is a sneak preview
of the website's Table of Contents:
Sources: See blogposts in Psychiatric Disorders: General and Psychiatric Disorders: Depression, Youtube
Additional Resources:
For related articles on the
Web, click on: “Sphere: Related Content” located at the bottom of this
blog post.
For related books or blog
posts with related content in Dr. Jeff’s and Dr. Tanya’s Blog type in the
keywords into “Google Search” located in
the sidebar.
For more books with related
content, type in the keywords into “Amazon
Search” on the Amazon banner located in the side bar.
Mental health professionals have long wondered about the
relationship between nightmares and mental health. An article published in
Medical News Today June 11, 2009, “Nightmares Predict Elevated Suicidal
Symptoms,” examines this issue. The article reports on a research abstract presented
at SLEEP 2009, the 23rd Annual Meeting of the Associated Professional Sleep
Societies. The researchers studied, “…82 men and women between the ages of 18
and 66, who were in a community mental health hospital admissions unit awaiting
an emergency psychiatric evaluation. Evaluations determined eligibility for
crisis stabilization inpatient admittance. Patients' nightmares, insomnia,
depression and suicidal tendencies were assessed through several
questionnaires, including the Disturbing Dreams and Nightmare Severity Index,
Insomnia Severity Index (ISI), Beck Depression Inventory (BDI), and the Beck
Scale for Suicide Ideation (BSS).” The results of the study were concerning.
“Results indicate that severe nightmares were independently associated with elevated
suicidal symptoms after accounting for the influence of depression, whereas
symptoms of insomnia were not. These findings suggest that nightmares stand
alone as a suicide risk factor.” There are several important implications of
this study. First, individuals whoa are experiencing chronic and persistent
nightmares who immediately consult with a mental health professional to
determine their risk of developing suicidal thinking. Second, mental health
professionals who treat patients who are experiencing suicidal thinking should
screen for the presence of nightmares. Third, public health professionals
should increase their efforts to educate that public about the relationship
between nightmares and suicidal thinking. The researches conclude, “Sleep disturbances,
especially nightmares, appear to be an acute warning sign and risk factor for
suicide….Given that poor sleep is amenable to treatment, and less stigmatized
than depression and suicide, our findings could impact standardized suicide
risk assessment and prevention efforts."
The Bottom Line:
The results of this study strongly suggest that nightmares are a risk factor
for suicidal thinking.
Sources: See blogposts in Psychiatric Disorders: General, Depression
Additional Resources:
For related articles on the
Web, click on: “Sphere: Related Content” located at the bottom of this
blog post.
For related books or blog
posts with related content in Dr. Jeff’s and Dr. Tanya’s Blog type in the
keywords into “Google Search” located in
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content, type in the keywords into “Amazon
Search” on the Amazon banner located in the side bar.
Mental health professionals have long debated about the
relationship between sleep deprivation and adolescent mental health. An article
published in Medical News Today June 11, 2009, “Link Between Depression,
Suicidal Thoughts and Later Parental-Mandated Bedtimes For Teens,” examines
this issue. The article reports on a research abstract presented at SLEEP 2009,
the 23rd Annual Meeting of the Associated Professional Sleep Societies. The
researchers studied 15,659 adolescents. The results were very concerning. “A
total of 1,143 teens (7.3 percent) suffered from depression and 2,038 (13
percent) had suicidal thoughts. Adolescents with parental-mandated bedtimes at
midnight or later were 25 percent more likely to suffer from depression and 20
percent more likely to have suicidal ideation compared with adolescents who had
parental-mandated bedtimes of 10 p.m. or earlier…..Adolescents with later
parental-mandated bedtimes went to bed later, got less sleep, and were less
likely to get enough sleep. Short sleep duration explained the relationship
between parental-mandated bedtimes and depression, functioning as a risk factor
for depression and suicidal ideation." There are several important
implications of this study. First, bedtimes matter for adolescents. Parents of
adolescents must mandate earlier bedtimes for their children or risk the
development depression and suicidal thinking. Second, mental health
professionals who treat adolescents who are depressed and suicidal must screen
these patients for sleep deprivation. Third, school professionals should
mandate a later start time for school for adolescents. Fourth, public health
professionals should increase their efforts to educate parents of adolescents
about the dangers of sleep deprivation. The authors conclude, “…It is a common perception
and societal expectation that adolescents do not need as much sleep as
preadolescents, yet studies suggests that adolescents may actually require more
sleep…Studies have found that adolescents do not go to bed early enough to
compensate for earlier school start times, and transitions to earlier school
start times have been shown to be associated with significant sleep
deprivation."
The Bottom Line: The results of this
study strongly suggest that sleep deprivation can cause depression and suicidal
thinking in adolescents.
Check out The Parent's Guide to Understanding Adolescent Depression
authored by Dr. Jeff and Dr. Tanya and now available in a great
informational website hosted by Squidoo.com. Below is a sneak preview
of the website's Table of Contents:
Sources: See blogposts in Psychiatric Disorders: General and Psychiatric Disorders: Depression, Youtube
Additional Resources:
For related articles on the
Web, click on: “Sphere: Related Content” located at the bottom of this
blog post.
For related books or blog
posts with related content in Dr. Jeff’s and Dr. Tanya’s Blog type in the
keywords into “Google Search” located in
the sidebar.
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content, type in the keywords into “Amazon
Search” on the Amazon banner located in the side bar.
Only about half of American children and teenagers who have certain
mental disorders receive professional services, according to a
nationally representative survey funded in part by the National
Institute of Mental Health (NIMH). The survey also provides a
comprehensive look at the prevalence of common mental disorders.
The
results are part of the National Health and Nutrition Examination
Survey (NHANES), a collaboration between NIMH and the National Center
for Health Statistics of the Centers for Disease Control and
Prevention. The survey conducted from 2001 to 2004 had 3,042
participants. These most recent results include data from children and
adolescents ages 8 to 15, and were published online ahead of print
December 14, 2009, in the journal Pediatrics.
"Data on the
prevalence of mental disorders among U.S. youth have been varied,
making it difficult to truly understand how many children and teens are
affected," said NIMH Director Thomas R. Insel, M.D. "These data from
the NHANES survey can serve as an important baseline as we follow
trends of mental disorders in children."
In the study, the young
people were interviewed directly. Parents or caregivers also provided
information about their children's mental health. The researchers
tracked six mental disorders—generalized anxiety disorder (GAD), panic
disorder, eating disorders (anorexia and bulimia), depression,
attention deficit hyperactivity disorder (ADHD) and conduct disorder.
The participants were also asked about what treatment, if any, they
were receiving.
Overall, 13 percent of respondents met criteria
for having at least one of the six mental disorders within the last
year. About 1.8 percent of the respondents had more than one disorder,
usually a combination of ADHD and conduct disorder. Among the specific
disorders,
8.6 percent had ADHD, with males more likely than females to have the disorder;
3.7 percent had depression, with females more likely than males to have the disorder;
2.1 percent had conduct disorder;
0.7 percent had an anxiety disorder (GAD or panic disorder);
0.1 percent had an eating disorder (anorexia or bulimia).
"With
the exception of ADHD, the prevalence rates reported here are generally
lower than those reported in other published findings of mental
disorders in children, but they are comparable to other studies that
employed similar methods and criteria," said lead author Kathleen
Merikangas, Ph.D., of NIMH.
Those of a lower socioeconomic status
were more likely to report any disorder, particularly ADHD, while those
of a higher socioeconomic status were more likely to report having an
anxiety disorder. Mexican-Americans had significantly higher rates of
mood disorders than whites or African-Americans, but overall, few
ethnic differences in rates of disorders emerged.
Merikangas and
colleagues also found that overall, 55 percent of those with a disorder
had consulted with a mental health professional, confirming the trend
of an increase in service use for childhood mental disorders,
especially ADHD. However, only 32 percent of youth with an anxiety
disorder sought treatment, a finding consistent with other studies.
Moreover, African-Americans and Mexican-Americans were significantly
less likely to seek treatment than whites, reiterating the need to
identify and remove barriers to treatment for minority youth, noted the
researchers.
"Until now, there has been a dearth of reliable data
on the magnitude, course and treatment patterns of mental disorders
among U.S. youth," said Dr. Merikangas. "When combined with data from
other nationally representative surveys, the data will provide a
valuable basis for making decisions about health care for American
youth," she concluded.
Source: National Institute of Mental Health
Additional Sources of Information:
Check out The Parent's Guide to Understanding Adolescent Depression
authored by Dr. Jeff and Dr. Tanya and now available in a great
informational website hosted by Squidoo.com. Below is a sneak preview
of the website's Table of Contents:
Sources: See blogposts in Psychiatric Disorders: General and Psychiatric Disorders: Depression, Youtube
Additional Resources:
For related articles on the
Web, click on: “Sphere: Related Content” located at the bottom of this
blog post.
For related books or blog
posts with related content in Dr. Jeff’s and Dr. Tanya’s Blog type in the
keywords into “Google Search” located in
the sidebar.
For more books with related
content, type in the keywords into “Amazon
Search” on the Amazon banner located in the side bar.
Depressed teens who report low levels of impairment related to drug
or alcohol use tended to respond better to depression treatment than
depressed teens with higher levels substance-related impairment,
according to an analysis of data from the NIMH-funded Treatment of
SSRI-Resistant Depression in Adolescents (TORDIA) study. However, it is
unclear whether less substance-related impairment allowed for better
response to depression treatment, or if better treatment response led
to less substance-related impairment. The study was published in the
December 2009 issue of the Journal of the American Academy of Child and Adolescent Psychiatry.
Background
Substance
use is more common among teens with depression than among those without
depression. Researchers have also found that depression can inhibit
teens' response to treatment of substance abuse, and substance abuse is
associated with a poorer response to treatment of depression. Still,
few trials have examined how coexisting depression and substance use
among teens may affect treatment outcomes for both.
In the TORDIA
study, 334 teens who did not respond to a type of antidepressant called
a selective serotonin reuptake inhibitor (SSRI) before the trial were
randomly assigned to one of four treatments for 12 weeks:
Switch to another SSRI
Switch to venlafaxine (Effexor), a different type of antidepressant
Switch to another SSRI and add cognitive behavioral therapy (CBT), a type of psychotherapy
Switch to venlafaxine and add CBT
Results of the trial were previously reported
in February 2008. They showed that teens who received combination
therapy, with either type of antidepressant, were more likely to
improve than those on medication alone.
In this new analysis,
Benjamin Goldstein, M.D., of the University of Toronto, and colleagues
examined TORDIA data to determine the relationship, if any, between
substance use, major depression and response to depression treatment.
Substance use was defined as using alcohol or drugs without meeting
criteria for having a full-blown substance abuse disorder. Teens who
were diagnosed with a substance abuse disorder were excluded from the
TORDIA study.
Results of the Study
Substance use was
fairly common among TORDIA participants. At baseline, about 28 percent
reported experimenting with drugs or alcohol. Those who showed more
substance -related impairment were older, felt more hopeless, had
greater family conflict, developed depression at an earlier age, were
more likely to have a history of physical or sexual abuse, and were
more likely to have coexisting oppositional defiant disorder (ODD) or
conduct disorder (CD). Substance-related impairment included certain
attitudes and behaviors such as craving the substance, feeling hooked
on it, accidentally hurting oneself or others while using it, and other
similar effects.
Participants with low levels of substance use
and substance-related impairment throughout the study tended to respond
better to depression treatment than those who showed persistently high
or increasing levels of substance-related impairment. There were no
significant differences in rates of substance use and impairment among
the treatment groups.
Significance
This study is one of
the first to examine the association between substance use and
depression treatment among depressed teens. The findings are consistent
with other studies that found depression severity to be associated with
a history of physical or sexual abuse, coexisting ODD or CD, and
substance-related impairment. However, the direction of the association
is uncertain. The data could not determine whether low
substance-related impairment facilitates improvement in depression
symptoms, or whether improvement in depressed mood leads to a decrease
in substance-related impairment.
What's Next
The authors
caution that the study does not provide definitive conclusions about
depression treatment and substance use. However, they do suggest that
clinicians treating teens for depression screen for signs of substance
use and address those issues as well, even if the teen does not meet
criteria for a full-blown substance abuse disorder.
Reference
Goldstein
BI, Shamseddeen W, Spirito A, Emslie G, Clarke G, Wagner KD, Asarnow
JR, Vitiello B, Ryan N, Birmaher B, Mayes T, Onorato M, Zelazny J,
Brent D. Substance use and the treatment of resistant depression in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry. 2009 Dec. 48(12):1182-1192.
Source: National Institute of Mental Health
Additional Sources of Information:
Check out The Parent's Guide to Understanding Adolescent Depression
authored by Dr. Jeff and Dr. Tanya and now available in a great
informational website hosted by Squidoo.com. Below is a sneak preview
of the website's Table of Contents:
Sources: See blogposts in Psychiatric Disorders: General and Psychiatric Disorders: Depression, Youtube
Additional Resources:
For related articles on the
Web, click on: “Sphere: Related Content” located at the bottom of this
blog post.
For related books or blog
posts with related content in Dr. Jeff’s and Dr. Tanya’s Blog type in the
keywords into “Google Search” located in
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content, type in the keywords into “Amazon
Search” on the Amazon banner located in the side bar.
Children with autism who receive a high intensity developmental
behavioral intervention starting by age 18-30 months show major
improvements in IQ, language, adaptive behavior, and severity of their
diagnosis, according to an NIMH-funded study.
Background
Current
guidelines by the American Academy of Pediatrics recommend screening
children for autism spectrum disorder (ASD) by age 18 months. However,
no randomized clinical trials of intensive interventions for this age
group had been conducted.
To address this gap, Geraldine Dawson,
Ph.D., who was at the University of Washington at the time of the
study, and colleagues randomly assigned 48 children, ages 18-30 months,
to one of two intervention groups:
Early Start Denver Model
(ESDM), a comprehensive, developmental behavioral intervention designed
for toddlers with ASD as young as 12 months old. ESDM combines aspects
of applied behavioral analysis (ABA) with developmental and
relationship-based approaches.
Assess and Monitor (A/M), the
comparison group intervention in which parents received recommendations
on ASD interventions for their children, as well as referrals to local
community providers of the interventions. A/M represents typical
community-based care.
Children in the ESDM group were
provided 20 hours per week of therapy from study clinicians, while
their parents received related training to use ESDM strategies for at
least five additional hours per week during their daily activities.
Parents of all study participants were also free to receive other
community services they thought appropriate.
All children in the
study had been diagnosed with autism or a milder form of ASD called
pervasive developmental disorder not otherwise specified (PDD-NOS).
They were assessed yearly for two years or until the child turned four
years old, whichever was longer.
Results of the Study
By
the first- year assessment, children in the ESDM group gained 15.4 IQ
points on average, while children in the A/M group gained an average of
4.4 points.
Over the two-year study period, children in the ESDM
group consistently improved on measures of communication skills. They
also showed improvements in motor skills, daily living skills, and
other adaptive behaviors.
While children in the ESDM group were
significantly delayed in their adaptive behaviors compared to typically
developing children, they showed similar rates of improvement. In
contrast, children in the A/M group fell further and further behind
over time.
By the end of the study, more children who had
received ESDM received improved diagnoses than children in the A/M
group—seven children initially diagnosed with autistic disorder had
their diagnosis change to PDD-NOS after receiving ESDM (30 percent),
compared to only one child in the A/M group (5 percent).
Significance
According
to the researchers, this is the first randomized controlled trial to
study a potentially useful intensive intervention for very young
children with ASD.
The study's findings suggest that ESDM can
help children with ASD achieve better outcomes in terms of IQ,
language, and behavioral skills, and in severity of their ASD
diagnosis, than if they receive community-based care. Compared to
research on other, similar interventions, this study showed greater
differences between groups, suggesting that ESDM, delivered at a very
young age, may be more effective than other approaches. The researchers
noted that parents' use of ESDM strategies at home may have been key to
this intervention's effectiveness.
What's Next
The University of Washington research team has been funded through the NIH Autism Centers of Excellence (ACE) program
to follow this study's participants to determine whether the effects of
ESDM can be sustained over time. In addition, Dr. Sally Rogers, Ph.D.,
a co-author on the study and co-developer with Dr. Dawson of the ESDM
model, is leading a multi-site, randomized clinical trial of ESDM, also
funded through the NIH ACE program. With a larger sample size, the
investigators hope to better understand factors that predict level of
response to the ESDM intervention.
For related articles on
autism spectrum disorders on the Web, click on: “Sphere: Related Content”
located at the bottom of this blog post.
For related books or blog posts with related content in Dr. Jeff’s and Dr. Tanya’s Blog, go to “Psychiatric Disorders: Autism Spectrum Disorders” or type in the keyword “Autism Spectrum disorders” into “Google Search” located in the sidebar.
For more books with related
content, click any hyperlinked keyword in the blog or type in the keyword,
“autism spectrum disorders” into “Amazon Search” on the Amazon banner
located in the side bar.
Sources: See blogposts in: Psychiatric Disorders: Autism
Spectrum Disorders, Youtube
Long-term treatment of adolescents with major depression is
associated with continuous and persistent improvement of depression
symptoms in most cases, according to the most recent analysis of
follow-up data from the NIMH-funded Treatment of Adolescents with
Depression Study (TADS). The report, along with a commentary compiling
the take-home messages of the study, was published in the October 2009
issue of the American Journal of Psychiatry.
Background
The
TADS team randomly assigned 439 adolescents aged 12 to 17 to one of
four treatment strategies for 36 weeks—the antidepressant fluoxetine
(Prozac) only, cognitive behavioral therapy (CBT) only, the combination
of the two, or placebo (inactive or "sugar" pill). After the first 12
weeks, the placebo group was discontinued, while the participants
assigned to the active interventions continued treatment for another
six months. Overall, the combination therapy was found to be the most
effective in speeding up remission. Visit the NIMH website for more information about TADS results.
After
the trial ended, the teens who had been assigned to the active
treatments were assessed up to four times during the following year to
determine if improvements were sustained over time. TADS treatments
were no longer offered, but participants were encouraged to continue to
seek treatment within their communities.
Participants who had
been assigned to the placebo group received open treatment during the
one-year follow-up period and were not included in this follow-up
assessment. About 66 percent of TADS subjects (not including those who
had been in the placebo group) participated in at least one assessment
during the follow-up year.
Results of the Study
By the
end of the 36-week trial, 82 percent of participants had improved and
59 percent had reached full remission. During the follow-up year, most
participants maintained their improvements, and the remission rate
climbed to 68 percent. However, about 30 percent of the participants
who were in remission at week 36 became depressed again during the
following year.
In addition, while 91 percent of participants
showed no evidence of suicidal thinking or behavior at the end of the
trial, 6 percent developed suicidal thinking during the follow-up year,
with no statistically significant differences among the treatment
groups.
Significance
The longer-term treatment of TADS,
regardless of treatment strategy, was associated with lasting benefits
for the majority of participants. However, a significant number of
those who had recovered worsened during the follow-up period,
indicating a need for continuous clinical monitoring and further
improvement in long-term treatment of youth with major depression.
What's Next?
The
final results of TADS suggest that for most teens with depression,
long-term, evidence-based treatments are effective and sustainable. But
future research should concentrate on improving treatment strategies to
reduce the rate of depression relapse or deterioration. The authors
suggest that a randomized maintenance therapy trial would help
determine how long active treatment should last to ensure the effects
of treatment will endure over time.
References
TADS Team. The Treatment for Adolescents with Depression Study (TADS): Outcomes over one year of naturalistic follow-up. American Journal of Psychiatry. 2009 Oct. 166(10): 1141-1149.
March JS and Vitiello B. Take home messages from the Treatment for Adolescents with Depression Study (TADS). American Journal of Psychiatry. 2009 Oct.166(10):1118-1123.
Source: National Institute of Mental Health
Additional Sources of Information:
Check out The Parent's Guide to Understanding Adolescent Depression
authored by Dr. Jeff and Dr. Tanya and now available in a great
informational website hosted by Squidoo.com. Below is a sneak preview
of the website's Table of Contents:
Sources: See blogposts in Psychiatric Disorders: General and Psychiatric Disorders: Depression, Youtube
Additional Resources:
For related articles on the
Web, click on: “Sphere: Related Content” located at the bottom of this
blog post.
For related books or blog
posts with related content in Dr. Jeff’s and Dr. Tanya’s Blog type in the
keywords into “Google Search” located in
the sidebar.
For more books with related
content, type in the keywords into “Amazon
Search” on the Amazon banner located in the side bar.
